Low-density Lipoprotein Reduction Research Articles

The Effect of Prebiotics, Alone or as Part of Synbiotics, on Cardiometabolic Parameters in Women with Polycystic Ovary Syndrome: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Background/Objectives: This systematic review and meta-analysis aimed to investigate the effect of prebiotics, alone or as part of synbiotics, on cardiometabolic parameters in polycystic ovary syndrome (PCOS) women. Methods: Databases, including PubMed, Scopus, ISI Web of Science, Embase, and the Cochrane Central Register of Controlled Trials, were searched for relevant randomized-controlled trials (RCTs) until 12 December 2024. Changes in mean ± standard deviations were extracted and combined using a random-effects model. Bias was assessed using Cochrane risk of bias and evidence quality with GRADE. Results: Twenty RCTs with 1271 participants were included. Results showed high-quality evidence supporting prebiotics’ effects, alone or as part of synbiotics, in reducing body-mass index [n = 853; weighted-mean difference (WMD): −0.510, 95%CI: −0.669, −0.351 kg/m2] and diastolic blood pressure (WMD: −2.218, 95%CI: −4.425, −0.010 mmHg), moderate-quality evidence for weight, waist-to-hip ratio, and triglycerides improvements, and low or very-low-quality evidence for waist circumference (WC), fat mass, fasting plasma glucose, fasting insulin, low-density lipoprotein (LDL), total cholesterol (TC), high sensitive-C reactive protein, total testosterone, follicle-stimulating hormone and free androgen index improvements. Subgroup analyses revealed possible reduction in LDL with prebiotics, as well as possible decreases in WC, TC, and total testosterone with synbiotics. Dietary approaches to stop hypertension diet improved insulin sensitivity. Conclusions: This study suggests that prebiotics may beneficially affect several cardiometabolic parameters in PCOS women. Approximately one-third of the results were based on moderate-to-high-quality evidence. This study highlights the need for future well-designed, larger RCTs with longer treatment duration to strengthen the evidence base and guide clinical decision-making.

Sleeve gastrectomy plus single anastomosis sleeve ileal bipartition versus sleeve gastrectomy alone: The role of bipartition.

Sleeve gastrectomy (SG) with single anastomosis sleeve ileal bipartition (SASI) is a novel procedure for increasing the anti-metabolic efficacy of SG in severely people with obesity. This study aimed to compare 1-year results between SASI and SG, thereby assessing the role of bipartition. The study was conducted at the Medical University hospital. Between November 2021 and December 2022, 39 patients received an SG + SASI surgery, a total of 35 patients completed 1-year follow-up after the surgery. They were matched with a group of 70 patients with SG that were equal in age, sex, and body mass index (BMI). Operative risk, weight loss, and remission of comorbidities were evaluated after 12 months. The operation time of the SASI group was significantly longer than the SG group (140.3 ± 22.8 vs. 114.9 ± 21.6 min; p < .001). At 12 months after surgery, the SASI group had better weight loss (total weight loss: 37.0% vs. 29.7%; p = .001) and achieved a lower BMI than SG (23.4 ± 2.6 kg/m2 vs. 24.6 ± 2.9 kg/m2; p = .046). Reduction of A1C and remission of T2D was greater in the SASI group. The SASI group had a higher reduction in uric acid, low-density lipoprotein, total cholesterol, and triglyceride levels after operation than the SG group. However, the SG group is superior to the SASI group in mean corpuscular volume, calcium, and iron levels. In this study, adding an ileum bipartition to SG increases the weight loss, glycemic, and blood lipid control of SG only.

Atherogenic low-density lipoprotein and cardiovascular risk.

Despite reductions in low-density lipoprotein (LDL) cholesterol (LDLc), residual cardiovascular risk remains due to factors beyond lipoprotein levels, such as LDL particle count, size, electronegativity and modifications. Technological advances allow detailed profiling of LDL particles, offering potential biomarkers for diagnosis, prognosis, and treatment of cardiovascular disease (CVD). The aim of this review is to provide an updated overview of the state of knowledge in the field of LDL atherosclerotic role, which is evolving rapidly due to technological advances in biomarker measurement and applications. While small dense LDL has been linked to increased CVD risk, current approaches favor a comprehensive evaluation of all lipoprotein subtypes, as this is a more feasible and standardized method. The atherogenic potential of circulating oxidized LDL (oxLDL) may be the key factor in the onset and progression of atherosclerosis. Thus, elevated oxLDL levels are recognized as a marker of increased CVD risk in both general and high-risk populations, although further research is needed to clarify some conflicting findings. The oxidized LDL receptor 1 (LOX-1) has emerged as a promising target for immunotherapy and innovative drug delivery strategies to modulate atherosclerosis. A panel of biomarkers related to LDL atherogenicity may help predict future ischemic events. An atheroprotective diet and increased physical activity could improve LDL oxidation. OxLDL has become a target for immunomodulatory antiatherosclerosis therapy and delivering LDL-based nanocarriers holds promise for both imaging and therapeutics.

The role of the Mediterranean Diet in preventing the development and complications of lifestyle diseases – a Review

IntroductionThe Mediterranean diet, inspired by traditional dietary habits of the Mediterranean region, exhibits anti-inflammatory and protective effects, reducing the risk of civilization diseases such as obesity, type 2 diabetes, and cardiovascular disorders. This diet is characterized by a high intake of plant-based foods, olive oil, and moderate consumption of fish and dairy products. These components provide unsaturated fatty acids, polyphenols, and antioxidants, which positively impact metabolic health and lower the risk of chronic diseases. In the face of the global obesity epidemic and an increasing number of individuals affected by lifestyle-related diseases, the Mediterranean diet offers a promising tool to support a healthy lifestyle. Aim of study This article aims to review current scientific studies evaluating the potential of the Mediterranean diet in preventing and managing civilization diseases. Particular attention is given to its effects on weight loss, improvements in glycemic markers, reductions in low density lipoproteins (LDL) cholesterol levels, and blood pressure control. The article also explores its benefits for athletes' health, as well as its potential to reduce oxidative stress and inflammatory states. Material and methods A literature review of the PubMed database was conducted, assessing relevant studies on the Mediterranean diet and its impact on lifestyle diseases.

Abstract 4116298: Once Weekly Utreglutide (GL0034), a Glucagon-like Peptide-1 Receptor Agonist, at 4 × 450 µg Doses Reduces Blood Pressure, Lipids, and Body Weight in Post-menopausal Females: A Phase I Study

Background: Utreglutide (GL0034), a novel, once weekly glucagon-like peptide-1 receptor agonist (GLP-1RA), previously demonstrated significant reductions in body weight (BW) after a single dose ascending study in individuals with obesity . BW reductions after pharmacological treatment of obesity with GLP-1RA is associated with blood pressure (BP) lowering effects. Aim: This phase I study assessed the safety, tolerability, and cardio-metabolic effects of utreglutide after multiple ascending doses in post-menopausal female volunteers with overweight and obesity. Methods: In this randomized, double-blind, placebo-controlled study 12 post-menopausal female volunteers with overweight/obesity, aged 18 to 65 years old with a body mass index (BMI) ≥26 kg/m 2 were randomized (9:3) to subcutaneous utreglutide fixed doses (4 × 450 µg); or placebo once weekly for four weeks. Safety, tolerability, and key cardio-metabolic parameters were assessed. Biomarker measurements included oral glucose tolerance test (OGTT) insulin and glucose area under the curve (AUC), systolic- and diastolic BP, lipid profile (triglycerides (TG), total cholesterol (TC), low density lipoprotein (LDL), and non-high-density lipoprotein (non-HDL), creatinine, potassium, BW and leptin. Results: Utreglutide was generally well tolerated and related adverse effects were mainly gastrointestinal with dose-dependent nausea, vomiting and decreased appetite. Reductions in OGTT AUCs of insulin ( p &lt;0.05) and glucose ( p &lt;0.01) were noted on Day 23 after four weeks treatment with Utreglutide. This was accompanied by a decrease ( p &lt;0.001) in mean systolic and diastolic BP on Day 23 from baseline (BL). On Day 23, significant reductions in TC ( p &lt;0.01), LDL ( p &lt;0.05) and non-HDL ( p &lt;0.05) were observed. BW reduction versus BL ( p &lt;0.001) was 2.0 kg and 1.8 kg respectively on Day 29 and End of Study (EoS). Leptin levels significantly reduced from BL on Day 23 ( p&lt; 0.01) and EoS ( p &lt;0.001). No significant changes were observed for TG, creatinine and potassium (Table). Conclusions: Once weekly utreglutide dosing for four weeks at a dose of 450 µg in post-menopausal females with overweight and obesity, demonstrated clinically relevant reductions of systolic and diastolic BP. This was associated with improved performance of OGTT AUC of insulin and glucose, lipids, BW and leptin with an overall good tolerability and with potential to demonstrate cardio-metabolic benefits.

Reversal of Atherosclerotic Plaque Growth and Vulnerability: Effects of Lipid-Modifying and Anti-Inflammatory Therapeutic Agents.

Atherosclerotic plaque development constitutes the primary substrate of coronary artery disease (CAD) and is the outcome of an intricate process involving endothelial damage, inflammation, and lipid retention. The clinical efficacy of many lipid-lowering therapies in patients with CAD has been well established. Over the past few decades, a substantial and significant advance regarding the use of invasive and non-invasive imaging modalities has been observed. Numerous studies have been conducted using these imaging techniques and have investigated the changes in morphology (e.g., atheroma volume) and composition (e.g., lipid burden, fibrous cap thickness, macrophage accumulation) at the plaque level that explain the improved clinical outcomes by various pharmacological interventions. Lipid-lowering agents, such as statins and proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors, demonstrate direct effects on plaque volume and composition that enhance plaque stabilization and/or regression beyond the reduction of low-density lipoproteins. An increasing amount of clinical research is also focused on the role of inflammation in plaque vulnerability and future adverse cardiac events. Consequently, there is a pressing need to explore therapeutic strategies that are capable of disrupting the inflammatory response as well as reducing atheroma burden and modifying high-risk plaque characteristics. This review provides a comprehensive analysis of the current evidence regarding the effects of traditional and novel therapeutic strategies targeting modification of the lipid profile and inflammatory processes on reversing plaque growth and attenuating vulnerable features, thereby promoting plaque stabilization and passivation.

Dynamics of Blood Lipids Before, During, and After Diurnal Fasting in Inactive Men: Quasi-Experimental Study.

There is a lack of investigation into the dynamics of blood lipids before, during, and after diurnal fasting, especially in inactive men. This study determined dynamic changes in blood lipids in inactive men before, during, and after they underwent diurnal fasting. A total of 44 young men aged a mean 27.6 (SD 5.8) years were recruited to evaluate their habitual physical activity and diet using a questionnaire developed for this study. Body composition was evaluated using a bioelectrical impedance analysis machine (Tanita BC-980). An 8-ml blood sample was collected to evaluate blood lipids and glucose. All measurements were taken 2-3 days before Ramadan, during Ramadan (at week 2 and week 3), and 1 month after Ramadan. A 1-way repeated measures ANOVA was used to compare the measured variables before, during, and after the month of Ramadan. When a significant difference was found, post hoc testing was used. Differences were considered significant at P<.05. There was a significant reduction in low-density lipoprotein during Ramadan compared to before and after Ramadan (83.49 mg/dl at week 3 vs 93.11 mg/dl before Ramadan [P=.02] and 101.59 mg/dl after Ramadan [P=.007]). There were significant elevations in fasting blood glucose (74.60 mmol/L before Ramadan vs 81.52 mmol/L at week 3 [P=.03] and 86.51 mmol/L after Ramadan [P=.01]) and blood pressure (109 mm Hg before Ramadan vs 114 mm Hg after Ramadan; P=.02) reported during and even after the month of Ramadan, although both fasting blood glucose and blood pressure were within normal levels. Ramadan fasting could be an independent factor in reducing low-density lipoprotein. Further investigations are encouraged to clarify the impact of diurnal fasting on blood lipids in people with special conditions.

Effects of metformin and curcumin in women with polycystic ovary syndrome: A factorial clinical trial

BackgroundPolycystic ovary syndrome (PCOS) is a common endocrine disorder in women, associated with dyslipidemia, insulin resistance, and hormonal imbalances. Metformin and curcumin have shown promise in improving these metabolic and hormonal parameters individually, but their combined effects in PCOS remain unclear. MethodsWe conducted a randomized, double-blind, placebo-controlled, 12-week factorial trial involving 200 women with PCOS. Participants were randomly assigned in a 1:1:1:1 ratio to receive metformin (500-mg/8 h) + placebo, nanocurcumin soft gel capsule (80-mg/8 h) + placebo, metformin (500-mg/8 h) + nanocurcumin (80-mg/8 h), or double placebo. Lipid profiles, glucose metabolism markers, hormonal parameters, body weight, and body mass index (BMI) were assessed at baseline and week 12. ResultsThe combination of metformin and curcumin demonstrated significant improvements in lipid profiles, glucose metabolism, hormonal parameters, body weight, and BMI compared to individual agents or placebo. Greater reductions in low-density lipoproteins (LDL) cholesterol, total cholesterol (TC), and triglyceride (TG) levels were observed with the combination therapy, along with increased high-density lipoproteins (HDL) cholesterol. Additionally, the combination therapy significantly improved markers of glucose metabolism and showed synergistic effects in reducing body weight and BMI. Reductions in testosterone and improvements in Follicle-stimulating hormone (FSH) and Luteinizing hormone (LH) levels were also observed with combination therapy. ConclusionThe combination of metformin and curcumin demonstrates superior efficacy in improving lipid profiles, glucose metabolism, hormonal parameters, body weight, and BMI in women with PCOS compared to individual agents or placebo. This highlights the potential synergistic effects of combining these agents for the management of PCOS.

Optimization of Hypercholesterolemia Treatment after Heart Transplant: The Role of PCSK9 Inhibitors.

Previous studies have reported the benefit of statins after heart transplant (HT). However, the use of high-dose statins might be limited in some HT patients due to intolerance and interactions with immunosuppression or might not be enough to achieve low-density lipoprotein (LDL) cholesterol goals. Hyperlipidemia has been associated with coronary allograft vasculopathy. Proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors might be a safe and effective option in HT patients with suboptimal lipid control. In a retrospective study, we identified HT patients in our center with LDL cholesterol >100 mg/dL, after diet modifications and up-titration of statins to maximum tolerated dose, treated with PCSK9i. The primary endpoint was LDL reduction one month after, and secondary endpoints were the development of donorspecific HLA antibodies (DSA) and the presence of coronary allograft vasculopathy or rejection. From January, 2018, to January, 2024, we identified five HT patients treated with PCSK9 inhibitors. In all cases, evolocumab was used. A significant reduction in LDL cholesterol was observed (151.6 ± 13.5 mg/dl to 72.4 ± 14.6 mg/dl; p = 0.04, mean reduction 75.7 ± 14.1 mg/dl), as well as in total cholesterol (231 ± 34.6 mg/dl to 152.2 ± 38.9 mg/dl; p < 0.01, mean reduction 78.8 ± 22.2 mg/dl). A significant increase in HDL cholesterol was not observed (45.4 ± 10.9 mg/dl to 46.2 ± 11.1 mg/dl; p = 0.60). One patient developed DSA five years after treatment onset. Rejection and coronary allograft vasculopathy were not observed. PCSK9 inhibitors are safe and effective in reducing LDL in HT patients. However, larger studies are needed to clarify if they can reduce the development of coronary allograft vasculopathy.

Ethanolic Extract Clove-loaded Chitosan Nanoparticles Reduce Dyslipidemia, Enhance Liver and Kidney Functions, and Improve the Antioxidant System in Obese Rats

Background: Obesity, a chronic low-grade inflammatory disease characterized by multiple metabolic dysfunctions, poses a considerable worldwide health risk to adults and children. Clove has also shown that it possesses anti-inflammatory, anti-fungal, antibacterial, antioxidant, antiglycation, and anti-aging properties. Aim: The current study aimed to investigate the antiobesity effect of clove-loaded chitosan nanoparticles in obese rats. objective: The current study investigated the antiobesity effect of clove-loaded chitosan nanoparticles in obese rats. Method: Obesity is induced in rats by the administration of a High-Fat Diet (HFD) for 4 weeks. 24 rats were divided into 4 groups; Control group, in which rats were fed normal; HDF group, in which rats were HFD along with distilled water; HFD + empty nanoparticles (ENPs), in which rats were HFD along with ENPs (45 mg/kg); and HFD + clove nanoparticles (CNPs), in which rats were HFD along with CNPs (45 mg/kg) for four weeks. Results: Administration of ENPs and CNPs led to a notable reduction in glucose, aminotransferases, alkaline phosphatase, cholesterol, triglycerides, low-density lipoproteins, malondialdehyde, nitric oxide, caspase-3, PCNA, leptin, and DNA fragmentation. Additionally, it promoted an increase in total proteins, albumin, high-density lipoprotein, glutathione, catalase, and adiponectin. Also, the histopathological investigation of the liver and kidney showed the protective effect of ENPs and CNPs on the tissues of obese rats. Conclusion: The present investigation elucidated the preventive effects of chitosan nanoparticles loaded with clove on dyslipidemia in obese rats. Clove nanoparticles exhibited hypolipidemia, antioxidant, hypoglycemia, and hepatoprotective activities.

Effectiveness of Omega-3 Polyunsaturated Fatty Acids in Non-alcoholic Fatty Liver Disease: A Systematic Review and Meta-Analysis.

Non-alcoholic fatty liver disease (NAFLD) is a prevalent liver disorder characterized by excessive hepatic fat accumulation without alcohol intake. It can progress to non-alcoholic steatohepatitis, increasing the risk of cirrhosis and liver failure. This study aims to evaluate the efficacy of omega-3 polyunsaturated fatty acids (n-3 PUFAs) in treating NAFLD. A systematic review and meta-analysis was conducted including studies published from January 2018 to June 2023. Databases searched included PubMed, Embase, Cochrane Library, and ClinicalTrials.gov. Inclusion criteria comprised randomized controlled trials and cohort studies involving human subjects or animal models with NAFLD. Data were extracted and analyzed to assess the impact of omega-3 PUFAs on liver fat, hepatic enzymes, and serum lipid profiles using RevMan 5.4. A total of 15 studies met the inclusion criteria. Omega-3 supplementation significantly decreased alanine aminotransferase (ALT) (mean difference = -2.12, 95% confidence interval (CI) = -3.36, -0.87) and aspartate aminotransferase (AST) (mean difference = -1.50, 95% CI = -2.59, -0.42). Gamma-glutamyl transferase levels showed a trend toward reduction (mean difference = -0.82, 95% CI = -1.66, 0.02). Serum lipid profiles improved significantly with reductions in triglycerides, low-density lipoprotein, and total cholesterol along with significant reductions in AST, ALT, and alkaline phosphatase in animal models. Omega-3 PUFAs appear to offer beneficial effects on liver enzymes, serum lipid profiles, and anthropometric indices in NAFLD patients. While their impact on liver fat content remains uncertain, omega-3 supplementation could serve as a valuable adjunct treatment for enhancing metabolic profiles and liver function in NAFLD patients.

Effect of aerobic and resistive exercise on lipid profile and quality of life in overweight breastfeeding women: A randomized controlled trial.

Breastfeeding provides benefits for both mothers and babies. However, many women experience postpartum weight gain, unfavorable lipid profiles, and other postpartum problems that can adversely impact their overall quality of life (QoL). To examine the effect of adding aerobic and resistive exercise to faradic stimulation and nutritional counseling on lipid profile and QoL in overweight breastfeeding women. Fifty-four breastfeeding women were randomly allocated into two equally sized groups. Group A underwent abdominal faradic stimulation along with nutritional counseling for 12weeks, whereas Group B received identical faradic stimulation and nutritional counseling and engaged in a combined aerobic and resistive exercise program for the same duration. Before and after treatment, the following anthropometric measurements were evaluated: body mass index (BMI), waist-to-hip ratio (W/H); lipid profile analysis, such as high-density lipoprotein (HDL), low-density lipoprotein (LDL), and triglycerides (TG); and the Short Form 36 Health Survey Questionnaire (SF-36). All outcome measures demonstrated significant improvements within the two groups (p<0.05). Group B showed more significant reductions in BMI, W/H ratio, and LDL, along with greater significant increases in the SF-36 domain scores for physical functioning, physical health problems, bodily pain, general health, energy/fatigue, social activity, mental health, and the total SF-36 score (p<0.05) compared to group A post-treatment. However, there were no significant differences in HDL, TG, and the score of the emotional wellbeing domain of the SF-36 between the groups after treatment (p>0.05). 12-week aerobic and resistive exercise is effective in reducing the BMI, W/H ratio, and LDL levels and enhancing the QoL in overweight breastfeeding women.

Effectiveness of high intensity and sprint interval training on metabolic biomarkers, body composition, and physical fitness in adolescents: randomized controlled trial.

The aim of this study was to evaluate the effect of HIIT and SIT programmes on body composition, blood pressure, lipid profile, glucose, cardiorespiratory fitness, and strength of adolescents and to compare the effect between those different protocols. Sixty adolescents were recruited from a high school and were randomly placed into three groups. SIT and HIIT undertook a training for 8 weeks, twice a week, for 12 min per session, during their Physical Education lessons. SIT group performed 6 sets of 60 s of work (90-95%HRmax) / 60 s of rest (50-55%HRmax), and HIIT group performed 3 sets of 2 min of work (80-85%HRmax) / 2 min of rest (50-55%HRmax). After adjustment by sex, both experimental groups exhibited a significant reduction in fat mass (p < 0.01), and trunk fat mass (p < 0.01), as well as a significant increase in lean mass (p = 0.01; <0.01), hand-grip strength (p < 0.01) and standing long jump (p = 0.05-0.04, respectively). In addition, HIIT showed a significant (p < 0.05) improvement in blood pressure, diastolic blood pressure, heart rate and VO2max, and a tendency toward a significant reduction in low density lipoprotein. The implementation of a HIIT protocol within high school Physical Education sessions, maintained for 8 weeks, at a rate of 3 sets of 2 min of work (80-85% RHR)/2 min of rest (50-55% RHR) generated adaptations such as improved fitness condition, changes in body composition, and improvements in blood parameters and blood pressure. However, the group of adolescents who performed SIT, shorter but more intense sets, did not experience as many benefits.

SAFETY AND EFFICACY OF BEMPEDOIC ACID AS A MONO AND COMBINED THERAPY IN STATIN HYPERLIPIDEMIC PATIENT: A SYSTEMATIC REVIEW

Cardiovascular diseases (CVD) are the prominent cause of death both in the United States and worldwide. Hyperlipidemia is the primary risk factor that leads to atherosclerosis and several other vascular diseases. statin therapy has been the most prescribed therapy for hyperlipidemia for almost three decades, but the prescription comes with some adverse side effects. Bempedoic acid is a novel oral drug recently approved by the FDA for hyperlipidemia patients especially it is beneficial for those who are facing statin intolerance. The studies were collected from different databases i.e. PubMed, clinicaltrails.gov, web of Science, and Google Scholar. The selection criteria were based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline. The phase 2 trials showed reducing Low-density lipoproteins (LDL) by 27% at a dosage of 120 mg of Bempedoic acid. When Bempedoic acid and ezetimibe are administered alone, LDL-C levels are reduced by 13-23% and 13-20%, respectively. Bempedoic acid+ atorvastatin causes a reduction of LDL to 22%, but with a placebo treatment, there will be no reduction in LDL level. Bempedoic acid 120 mg plus ezetimibe 10mg LDL-C levels decreased by 43% and 48% with Bempedoic acid 180 mg plus ezetimibe 10mg. Bempedoic acid has an interesting biochemical profile and presents an interesting new option for managing the complex dyslipidemia issue. The FDA has approved Bempedoic acid and Bempedoic acid plus antihyperlipidemic agents for the treatment of people with Heterozygous Familial Hypercholesterolemia (HeFH) or established atherosclerotic cardiovascular disease (ASCVD) who need further LDL-C reduction with statin therapy that is maximally tolerable.

Influence of the remote monitoring system on the lipid profile after myocardial infarction in urban and rural areas of the Perm region

Objective: to evaluate the impact of a remote dynamic monitoring system on the lipid profile after myocardial infarction in urban and rural areas of the Perm Territory. Material and methods. The study, conducted between 2020 and 2022, included 253 patients diagnosed with myocardial infarction. The study compared two groups of patients: those who refused to participate (n=105) and those who took part in the "Remote health monitoring of patients with cardiovascular disease" (RM program) (n=148). Patients were monitored at least once a month via telephone calls using an approved list of questions. Results. The group of patients participating in the RM system showed a significant improvement in lipid profile compared to the groups without RM. A comparison between urban and rural patients showed statistically significant differences in the levels of cholesterol (p=0.002 for residents of the Perm region) and low-density lipoproteins (LDL) (p=0.049 for residents of Perm; p=0.025 for residents of the Perm region), indicating potential differences in the effect of RM in different areas. Patients in the RM group from the Perm region were 15.56 times more likely to achieve target LDL levels compared to a similar group without RM. Conclusion. The RM system had a positive effect on the reduction of LDL and cholesterol in groups of residents, both in urban and rural areas.

Evaluation of chapattis fortified-diet with raw and fermented carrot powder in persons with type 2 diabetes: A randomized control pilot study

BackgroundDiabetes is a metabolic disease that is common and growing rapidly. It is characterised by high blood sugar levels and related complications to vital organs such as the kidneys, heart, blood vessels, and eyes. The most common kind of diabetes affecting people globally is type 2 diabetes (T2D). An increasing number of people are looking at natural foods and dietary supplements to manage their T2D.ObjectiveThe aim of this pilot study was to assess the glycemic index, glycemic response, sensory qualities, nutritional composition, and possible antidiabetic benefits of chapattis fortified with raw and fermented carrot powder.MethodsSeven preparations of chapattis were prepared into three variants from whole wheat flour chapattis (WWFC) as control group, raw carrot-supplemented chapattis (RCSC) with subtypes T1, T2, and T3, and fermented carrot-supplemented chapattis (FCSC) with subtypes T4, T5, and T6. The variants were provided to 11 professionally trained sensory panelists for organoleptic evaluation. The chapattis subtype with the best organoleptic properties together with the WWFC were then given randomly to a group of 30 persons with T2D respectively to see how their blood sugar levels were affected over a period of 4 weeks.Results The panelist adjudged RCSC (T2) and FCSC (T5) as the best organoleptically. The randomised control investigation demonstrated that the fasting blood glucose levels for WWFC, RCSC, and FCSC decreased (P&lt;0.05) significantly by 6.42%, 7.24%, and 12.75%, respectively. However, there was no significant different in the fasting blood sugar between the WWFC and RCSC. As for the glycemic load values of WWC, RCSC, and FCSC, which were 21, 14, and 13, respectively, there was no statistically significant difference between RCSC and FCSC, suggesting that both types of chapattis could help T2D patients regulate their blood sugar levels. The most significant changes were consistently shown by the FCSC: 17.50% reduction in random blood sugar (p = 0.03), 21.85% reduction in serum low-density lipoprotein (p = 0.051), 16.67% increase in serum HDL (p = 0.01), 11.09% decrease in serum cholesterol (p = 0.02), and 12.575% reduction in serum triglycerides (p = 0.048).ConclusionsA beneficial dietary intervention for people with T2D may involve mixing fermented carrot powder into regular chapattis. These findings contribute to the growing body of evidence in favour of using natural food-based treatments for the management of diabetes.

PCSK9 inhibition: from effectiveness to cost-effectiveness.

Dyslipidaemia is a complex disorder characterised by abnormal lipid levels in the blood, including cholesterol and triglycerides, and plays an important role in the development of atherosclerotic cardiovascular disease. Most risk factors for cardiovascular disease are modifiable, and dyslipidaemia is a key factor among them. It can result from a combination of genetic and environmental factors. A distinction is made between primary dyslipidaemia, which is mainly caused by inherited genetic changes, and secondary dyslipidaemia, which is due to underlying diseases or certain medications. The treatment of dyslipidaemia has evolved over the years. In the past, statins were the first choice, but newer drugs, such as proprotein convertase subtilisin-kexin type 9 (PCSK9) inhibitors, have gained prominence due to their effectiveness in lowering lipids. Although recent guidelines recommend PCSK9 inhibitors for high-risk patients and patients who cannot tolerate statins, their widespread use is limited because of cost. Several meta-analyses have confirmed the efficacy and safety of PCSK9 inhibitors and have shown a significant reduction in low-density lipoprotein (LDL) cholesterol levels. However, the long-term side effects and interactions with other risk factors for cardiovascular disease remain uncertain. In addition, cost-effectiveness analyses have shown mixed results, with some countries considering PCSK9 inhibitors to be cost-effective for certain patient groups, while others consider them less economical. Meanwhile, initial data from patients using PCSK9 inhibitors support the results of the clinical trials. To summarise, PCSK9 inhibitors represent a revolutionary solution for lowering LDL cholesterol, but their cost-effectiveness remains controversial. Despite the controversy, they offer clear benefits for high-risk patients and should therefore be considered in the treatment of dyslipidaemia.

Investigating the effect of levothyroxine replacement on cholesterol levels in hypothyroid patients

ABSTRACT Introduction: Effects of levothyroxine therapy on the lipid profile of hypothyroid patients lead to decrease in the risk of cardiovascular diseases and mortality. Objective: Overt or subclinical hypothyroid dysfunction has negative effects on lipid metabolism and leads to hypercholesterolemia that in turn increases the risk of cardiovascular diseases and mortality. In this matter, several interventional studies investigated the effects of levothyroxine therapy on the lipid profile of hypothyroid patients, and conflicting results have been obtained. The current research aims to investigate the effect of levothyroxine replacement on cholesterol levels in hypothyroid patients. Methods: The present prospective study examined 112 patients (mean age of 43.80 ± 14.36 years) with overt hypothyroidism. To do so, 72.3% of patients were females. Levothyroxine replacement therapy was prescribed for patients, and they were examined monthly to evaluate the effects of therapy on their lipid profiles. After reaching normal thyroid stimulating hormone (TSH), the patients’ laboratory parameters, including TSH, total cholesterol, low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, and triglycerides, were surveyed. Results: After Levothyroxine therapy, there was a significant reduction in mean TSH (62.03 vs. 2.33 ± 1.95; P &lt; 0.0001), triglycerides (145.57 ± 88.65 vs. 121.91 ± 59.52, P = 0.002), cholesterol (203.90 ± 53.73 vs. 166.65 ± 40.07, P &lt; 0.0001), and serum LDL (123.61 ± 45.03 vs. 95.99 ± 24.20, P &lt; 0.0001), but the mean value of serum HDL did not show any significant change (54.18 ± 16.60 vs. 51.59 ± 18.38, P = 0.274). Conclusions: Levothyroxine therapy has beneficial effects on lipid profile in patients with overt hypothyroidism because it decreases serum triglyceride, total cholesterol, and LDL. However, levothyroxine therapy does not significantly change HDL levels.

Phytochemicals profiling of Cassia fistula fruit extract and its effect on serum lipids and hematological parameters in high-fat diet-induced hyperlipidemic female rats.

Cassia fistula (C. fistula) has shown strong anti-inflammatory, hepatoprotective, antitussive, antibacterial, and antifungal properties and is being used for healing wounds and gastrointestinal illness. This study was planned to obtain fruit extract from C. fistula using ultrasonic-assisted extraction (UAE) technique and evaluated for phytochemical contents, anti-hyperlipidemia, and hematological parameters. The results showed that total phenolic (TPC), total flavonoids (TFC), condensed tannin (CT), and saponins were 13.07 mg GAE/g, 5.24 mg QE/g, 4.01 mg/g, and 27.55%, respectively, in the extract. Proximate composition of the extract showed 2.48%, moisture, 1.25% fat, 2.80% ash, 4.59% fiber, 11.93% protein, and 76.95% NFE. The 2, 2-diphenyl-1-picrylhydrazyl (DPPH) and ferric reducing antioxidant power assay (FRAP) activity was 63.30 μg/mL and 15.02 nmol/g, respectively. High-fat diet (HFD)-induced hyperlipidemic rats were orally administrated with 0.5 and 1.0 g of extract/kg body weight (bw) daily. The reduction of total cholesterol (TC: 90.83 ± 8.86 mg/dL), triglycerides (TG; 74.16 ± 9.10 mg/dL), and low-density lipoproteins (LDL; 74.83 ± 4.66 mg/dL) and increase of high-density lipoproteins (HDL; 41.83 ± 8.4 mg/dL) was observed. Significant changes in red blood cells (RBCs; 8.03 ± 0.67106/μL), mean corpuscular hemoglobin concentration (MCHC; 35.02 ± 1.78 g/dL), mean corpuscular hemoglobin (MCH; 18.00 ± 0.26 pg), and mean corpuscular volume (MCV; 55.36 ± 4.01 fL) at 1.0 g extract intake was observed. Extract administration also improved significantly liver enzymes, body weight, and liver morphology. Therefore, C. fistula extract can be effectively used as a therapeutic agent to improve serum biochemistry and hematological values.

Antilipidemic and Hepatorenal Effects of Aqueous Extracts of Terminalia catappa on Streptozotocin-induced Diabetic Rats

Aims: Diabetes mellitus, a condition characterized by glucose receptor abnormalities affecting glucose uptake, affects approximately 600 million individuals globally as of 2021. This study aimed to assess the antilipidemic and renal effects of aqueous extracts from the root bark and flowers of Terminalia catappa on streptozotocin-induced diabetic rats. Methodology: Twenty-five Albino rats weighing 160 – 300g were divided into five groups: A - normal control, B - diabetic control, C - diabetic treated with root bark extract, D - diabetic treated with flower extract, E - diabetic rats treated with glibenclimide. Diabetes was induced using streptozotocin (55mg/kg). The extracts (200mg/kg) were orally administered for 14 days, after which lipid profiles, renal and liver function tests were conducted. Results: There was a significant (p&lt;0.05) increase in total cholesterol, serum liver enzymes, and kidney markers in the diabetic control group compared to the normal control group. Treatment with the Terminalia catappa extracts for 14 days resulted in more than 20% decrease in urea (from 18.58 Mmol/L to between 11.58 and 13.92 Mmol/L), creatinine (from 343.56 Mmol/L to between 223.94 and 266.30 Mmol/L) and uric acid (from 570.54 µmol/L to between 413.55 and 440.62 µmol/L) concentrations by more than 20%, with the root bark extract showing the most significant effect. Additionally, the Terminalia catappa extract-treated groups exhibited a substantial (around 40%) reduction in serum liver enzymes compared to the diabetic control group. The hepatoprotective capacity of the root bark extract was similar to the glibenclimide-treated group. Furthermore, the extracts led to a 3% reduction in total cholesterol, triglycerides, and low-density lipoproteins, along with a significant increase in high-density lipoproteins. Conclusion: The aqueous root bark and flower extracts of Terminalia catappa demonstrate potentials for managing diabetes mellitus at the specified dosage.